Examining National Trends in Worker Health with the National Health Interview Survey

Transcription

1 Examining National Trends in Worker Health with the National Health Interview Survey Sara Luckhaupt, MD, MPH John Sestito, JD, MS Total Worker Health Symposium Coralville, IA November 28, 2012 National Institute for Occupational Safety and Health Division of Surveillance, Hazard Evaluations, and Field Studies

2 Outline Why examine national trends in worker health Background about the National Health Interview Survey (NHIS) Data available every year from the core NHIS questions NIOSH publications based on these data Data available from the 2010 NHIS Occupational Health Supplement NIOSH publications based on these data How to access NHIS data Conclusions: Implications for Total Worker Health TM

3 Why Examine National Trends in Worker Health? To track the burden of morbidity, disability, and specific health conditions among all US workers To compare these burdens among worker subgroups in order to prioritize limited public resources for occupational health To provide industry-specific estimates to industry stakeholders to prioritize industrywide interventions To provide industry-specific estimates to employers to benchmark the health of their workers against industry averages and prioritize organization-level interventions

4 The National Health Interview Survey (NHIS) Conducted by the National Center for Health Statistics (NCHS) since 1957 Cross-sectional, in-person household survey Multistage area probability design 35,000 40,000 households surveyed annually Consists of core questions and sponsored supplements Detailed demographic & health questions asked of 1 sample adult (& 1 sample child) from each family Core sample adult questions include industry and occupation Occupational health supplements: 1980,1988, 2010, 2015(?)

5 Data from Core Sample Adult Questionnaire: General Socio-demographics E.g., gender, age, education, race/ethnicity, household income Health Conditions Injuries/poisonings (3 month recall period) Acute conditions (e.g., head/chest cold in past 2 weeks) Chronic conditions (e.g., hypertension, diabetes, low back pain) Health Status E.g., bed days, activity limitations Health Behaviors E.g., tobacco & alcohol, physical activity, influenza vaccination Healthcare utilization E.g., insurance, usual place for care

6 Data from Core Sample Adult Questionnaire: Related to Work Employment status Industry and occupation (current job, unless retired) Class of worker (e.g., self-employed, government, private) Average number of hours worked per week Duration of employment Employer size Salary and Benefits Wage/salary Employer-sponsored health insurance Paid sick leave Days of work missed due to illness/injury

7 Some Recent NIOSH Peer-Reviewed Publications Based on Core NHIS Data Tak S, Calvert GM. Hearing difficulty attributable to employment by industry and occupation: An analysis of the National Health Interview Survey--United States, 1997 to J Occup Environ Med. 2008; 50: Luckhaupt SE, Tak SW, Calvert GM. The prevalence of short sleep duration by industry and occupation in the National Health Interview Survey. Sleep 2010;33(2): Syamlal G, Mazurek JM, Bang KM. Prevalence of lifetime asthma and current asthma attacks in U.S. working adults: an analysis of the National Health Interview Survey data. J Occup Environ Med. 2009:51(9): Bang KM, Syamlal G, Mazurek JM. Prevalence of Chronic Obstructive Pulmonary Disease in the U.S. Working Population: An Analysis of Data from the National Health Interview Survey.J Chronic Obstruc Pul Dis. 2009:6(5):

8 New Set of NIOSH Documents Based on Core NHIS Data, Collaboration between NIOSH and the Occupational Research Group at the University of Miami 8 separate documents for each 2006 National Occupational Research Agenda (NORA) sector See NIOSH Homepage for NIOSH-Issued Include charts and tables for 27 outcomes Prevalence by NORA Sector Prevalence by demographic subgroup within 1 NORA sector Gender, race, ethnicity, age group, education, insurance status

9 Example: Morbidity and disability among workers 18 years and older in the Healthcare and Social Assistance sector, pages

10 Sample Size by NORA Sector, NHIS Current US workers by NORA Sector, NORA Sectors # in NHIS Sample Estimated Annual Population Represented by Sample % of US Workforce Agriculture, Forestry & Fishing Sector 4,378 2,694, Construction Sector 13,626 9,442, Healthcare & Social Assistance Sector 27,304 16,548, Manufacturing Sector 26,679 17,581, Mining Sector , Services Sector 77,835 49,913, Transportation, Warehousing & Utilities Sector 12,871 8,317, Wholesale and Retail Trade Sector 33,505 21,885, Total 196, ,898,

11 Outcomes, NHIS : Health Status Reported decline in health (vs. 12 months ago) Fair or poor self-rated health Bed disability days (past 12 months) Mean number % with 2 Work loss days Mean number % with 6

12 Prevalence of fair or poor self-rated health status estimated for workers 18 years and older by NORA sectors, National Health Interview Survey, All NORA sectors 5.3 Agriculture, Forestry, and Fishing sector Mining sector Construction sector Manufacturing sector Wholesale and Retail Trade sector Transportation, Warehousing, and Utilities sector Services sector Healthcare and Social Assistance sector Prevalence (Percent (%))

13 Prevalence of fair or poor self-rated health status estimated for workers 18 years and older

14 Outcomes, NHIS : Physical Activity Limitations Health problems requiring use of special equipment Any functional limitations Hearing difficulty Visual impairment

15 Prevalence of any functional limitations estimated for workers 18 years and older by NORA sectors, National Health Interview Survey, All NORA sectors Agriculture, Forestry, and Fishing sector Mining sector Construction sector 17.8 Manufacturing sector Wholesale and Retail Trade sector Transportation, Warehousing, and Utilities sector Services sector Healthcare and Social Assistance sector Prevalence (Percent (%))

16 Outcomes, NHIS : Health and Chronic Conditions Cancer Hypertension Heart disease Asthma Diabetes Severe psychological distress

17 Prevalence of hypertension estimated for workers 18 years and older by NORA sectors, National Health Interview Survey, All NORA sectors Agriculture, Forestry, and Fishing sector Mining sector 23.2 Construction sector 15.1 Manufacturing sector 19.2 Wholesale and Retail Trade sector 15.3 Transportation, Warehousing, and Utilities sector 20.0 Services sector Healthcare and Social Assistance sector Prevalence (Percent (%))

18 Outcomes, NHIS : Health Care Utilization (past 12 months) No visit to primary care provider No contact with dentist Surgery Hospital emergency room visit

19 Prevalence of not having seen a primary health care provider during the past 12 months estimated for workers 18 years and older by NORA sectors, National Health Interview Survey, All NORA sectors 30.2 Agriculture, Forestry, and Fishing sector 46.1 Mining sector 36.1 Construction sector 49.5 Manufacturing sector Wholesale and Retail Trade sector Transportation, Warehousing, and Utilities sector Services sector Healthcare and Social Assistance sector Prevalence (Percent (%))

20 Outcomes, NHIS : Health Risk Factors or Behaviors Current smokers Current alcohol drinkers Obesity Meeting CDC recommendations for leisure time physical activity Lifetime HIV test No influenza vaccination (past 12 months) No pneumococcal vaccination (ever, among those 60)

21 Prevalence of not receiving an influenza vaccination during the past 12 months estimated for workers 18 years and older by NORA sectors, All NORA sectors Agriculture, Forestry, and Fishing sector Mining sector Construction sector Manufacturing sector Wholesale and Retail Trade sector Transportation, Warehousing, and Utilities sector Services sector Healthcare and Social Assistance sector Prevalence (Percent (%))

22 Purpose: To collect information on the prevalence and correlates of work-related health conditions and exposures in the US working population Beyond what is available from the core NHIS questions

23 Content of the 2010 NHIS-OHS Supplemental work history Current/most recent job Longest-held job Work organization factors Work arrangements Work hours/shifts Psychosocial occupational exposures Job insecurity Work-family imbalance Hostile work environment (harassment)

24 Content of the 2010 NHIS-OHS (cont.) Physical/chemical occupational exposures Potential skin hazards Outdoor work Second-hand smoke Vapors, gas, dust, or fumes Work-relatedness of common health outcomes Asthma Dermatitis Carpal tunnel syndrome Injuries

25 NIOSH Publications Based on 2010 NHIS-OHS American Journal of Industrial Medicine (online) Luckhaupt et al. Prevalence and work-relatedness of carpal tunnel syndrome in the working population, United States, 2010 Luckhaupt et al. Prevalence of dermatitis in the working population, United States, 2010 National Health Interview Survey. Calvert et al. The prevalence of selected potentially hazardous workplace exposures in the US Alterman et al. Prevalence rates of work organization exposures among workers in the U.S... Alterman et al. Job insecurity, work-family imbalance, and hostile work environment: prevalence data from the 2010 National Health Interview Survey

26 NIOSH Publications Based on 2010 NHIS-OHS Morbidity and Mortality Weekly Report Short sleep duration among workers United States, MMWR 2012; 61; QuickStats: Percentage of employed adults aged years who had carpal tunnel syndrome in the past 12 months, by sex and age group. MMWR 2011; 60; QuickStats: Percentage of employed adults aged years with current asthma, skin condition, or carpal tunnel syndrome who were told their condition was work-related, by sex. MMWR 2011; 60; Other Mazurek JM, Storey E. Physician-patient communication regarding asthma and work. Am J Prev Med Jul;43(1):72-5. Tsai, Rebecca. Shift Work and Cancer Screening: Do Women Who Work Alternative Shifts Undergo Recommended Cancer Screening. Poster #15

27 NORA Sector Profiles Based on 2010 NHIS-OHS (currently under review) Will be available online 13 profiles break sectors down by industry subsector and/or occupational category Charts and tables for 16 outcomes One profile compares all sectors Includes some additional outcomes

28 Sample Sizes for 2010 NHIS-OHS Sector Profiles US workers (employed in past 12 months) by NORA Sector, 2010 NORA Sectors # in NHIS Sample Estimated Population % of US Workforce Represented by Sample Agriculture, Forestry & Fishing Sector 269 2,307, Construction Sector 1,115 10,639, Healthcare & Social Assistance Sector 2,478 20,520, Manufacturing Sector 1,590 14,555, Mining and Oil and Gas Extraction Sectors , Public Safety Sector 204 1,771, Services Sector 8,467 73,941, Transportation, Warehousing & Utilities Sector 854 7,638, Wholesale and Retail Trade Sector 2,191 20,994, Total 17, ,978, Notes: 1. All sectors were defined by industry codes, except for Public Safety, which was defined by occupation codes. Public Safety workers in Service industries (n=188) are excluded from the Services Sector estimates; but, Public Safety workers in other industries are included in the estimates for those industry sectors in addition to being included in the Public Safety Sector estimates. 2. The Mining and Oil and Gas Extraction Sectors were combined due to small sample sizes.

29 Sample Results from 2010 NHIS-OHS By NORA Sector

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33 Sample Results from 2010 NHIS-OHS By Industry Subsector Transportation, Warehousing, and Utilities

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36 Accessing and Analyzing NHIS Data Public dataset available on NCHS website Multiple files for each year: Household, Family, Person, Sample Adult, Sample Child Extensive survey documentation and sample programs available Complex sample design requires special analytic procedures E.g., SAS survey procedures, SUDAAN NHIS data also available through the Integrated Health Interview Series (IHIS) website Created by University of Minnesota: Facilitates creation of multi-year data files Some online analytic capability

37 Conclusions: Implications for Total Worker Health TM Published estimates from the NHIS can be used to: Estimate the burden of morbidity, disability, and specific health conditions among US workers Prioritize limited public resources for occupational health Prioritize industrywide interventions NHIS data are publicly available for researchers or employers to: Calculate other national estimates of interest Including NHIS questions in workplace surveys allows researchers and employers to: Benchmark the health of their study population/ workers against NHIS national estimates

38 Acknowledgements NIOSH Geoff Calvert Marie Haring Sweeney Toni Alterman Aaron Sussell Jacek Mazurek NCHS Jim Dahlhamer Brian Ward University of Miami David Lee Evelyn Davila William LeBlanc Alberto Caban Martinez Lora E Fleming Sharon Christ Kathryn McCollister Kris Arheart